Avaliação da composição nutricional do composto lácteo à venda no mercado brasileiro / Evaluation of the nutritional composition of growing-up milk available in the Brazilian market

Introdução: A influência do consumo de composto lácteo na nutrição de crianças em primeira infância ainda é desconhecida, apesar de o produto movimentar um mercado multimilionário. Objetivo: Avaliar a composição nutricional do composto lácteo e a influência de seu consumo sobre as necessidades diárias de macronutrientes e energia de crianças pequenas. Métodos: A pesquisa foi dividida em três partes, sendo: a) avaliação da composição nutricional e ingredientes; b) comparação do composto lácteo brasileiro com uma proposta de padronização; c) cálculo de inadequação nutricional e influência do consumo de composto lácteo em crianças pequenas. Resultados: Foi possível categorizar o produto em três subgrupos, de acordo com os ingredientes, sendo: grupo 1 (soro de leite, açúcar e gordura vegetal), grupo 2 (adição de vitaminas e minerais) e grupo 3 (ampla lista de ingredientes, sem adição de açúcares e adição de bioativos). De forma geral, o composto lácteo tem como características: excesso de proteínas e açúcares de adição, predominância de gorduras saturadas, além de aditivos químicos. Em comparação com a proposta de composição ideal, o composto lácteo brasileiro excede todos os nutrientes analisados e, por fim, o consumo de dois copos de 200mL de composto lácteo por dia corresponde a 100% das necessidades diárias de proteína, sendo as crianças de 0 a 11 meses as mais prejudicadas. Conclusão: Independentemente do subgrupo e do ingrediente, o produto tem impacto negativo na saúde infantil, e quanto menor a idade de introdução, maior o impacto na saúde, podendo levar ao desenvolvimento de sobrepeso e obesidade.

Introduction: The influence of consuming growing-up milk on the nutrition of infants is still unknown, despite the product driving a multimillion-dollar market. Objective: To evaluate the nutritional composition of the growing-up milk and the influence of its consumption on the daily macronutrient and energy needs of young children. Methods: The research was divided into three parts, namely: a) evaluation of nutritional composition and ingredients; b) comparison of the Brazilian growing-up milk with a proposed standardization; c) calculation of nutritional inadequacy and the influence of growing-up milk consumption in young children. Results: It was possible to categorize the product into three subgroups based on ingredients, namely: group 1 (whey, sugar, and vegetable fat), group 2 (added vitamins and minerals), and group 3 (a wide range of ingredients, no added sugars, and addition of bioactives). Overall, the growing-up milk is characterized by excess protein and added sugars, a predominance of saturated fats, and the presence of chemical additives. Compared to the proposed ideal composition, the Brazilian growing-up milk exceeds all analyzed nutrients. Finally, consuming two 200mL glasses of growing-up milk per day corresponds to 100% of daily protein needs, with children aged 0 to 11 months being the most affected. Conclusion: Regardless of the subgroup and ingredient, the product has a negative impact on children's health, and the younger the age of introduction, the greater the impact on health, potentially leading to the development of overweight and obesity.

Cumplimiento del etiquetado de fórmulas para lactantes según el Código Internacional de Comercialización de Sucedáneos de la Leche Materna / Compliance with the labeling of commercial milk formulas according to the International Code of Marketing of Breast-Milk Substitutes

INTRODUCCIÓN: El Código Internacional de Comercialización de Sucedáneos de la Leche Materna de la Organización Mundial de la Salud (OMS) contribuye a proteger y promover la lactancia humana, para evitar que la comercialización aliente la utilización de sucedáneos. El objetivo fue evaluar el cumplimiento de las disposiciones del Código de la OMS respecto del etiquetado de fórmulas de inicio, fórmulas especiales, fórmulas de seguimiento y leches de crecimiento en la ciudad de Buenos Aires durante julio, agosto y septiembre de 2019. MÉTODOS: Se realizó un estudio observacional de tipo descriptivo, corte transversal y enfoque cualitativo en 93 etiquetas. Se aplicó la metodología propuesta por el Fondo de las Naciones Unidas para la Infancia (UNICEF), la International Baby Food Action Network (IBFAN) y el International Code Documentation Centre (ICDC) en el documento Herramienta Monitoreo del Código (2015). RESULTADOS: El 90,32% incumple al menos un requisito definido en el Art. 9 del Código de la OMS. El 88,17% de las etiquetas analizadas incumple por la presencia de textos e imágenes que desalientan la lactancia materna. DISCUSIÓN: Las etiquetas cumplen parcialmente los lineamientos del Código de la OMS según la herramienta de investigación utilizada. Por lo tanto, se sugiere garantizar la protección del derecho a la alimentación adecuada durante la primera infancia mediante el monitoreo, control y fiscalización del Código por parte de las autoridades sanitarias

Dez passos para o sucesso no aleitamento materno: influência na continuidade da amamentação / Ten steps to breastfeeding success: the influence on breastfeeding continuity / Diez pasos para una lactancia exitosa: influencia en la continuidad de la lactancia materna

Objetivo: Avaliar as evidências, de produções científicas brasileiras, acerca da influência dos 10 passos para o sucesso do aleitamento materno na continuidade da amamentação. Método: revisão integrativa de produções científicas brasileiras, desenvolvida em junho de 2017, nas bases eletrônicas de dados LILACS, SCOPUS e PUBMED. Resultados: a normatização da assistência interfere positivamente na continuidade da amamentação. Treinar a equipe de saúde aumenta a prevalência de aleitamento materno. Orientar as vantagens e o manejo da lactação protege contra mastites, aleitamento misto e desmame precoce. Aqueles que receberam apoio no aleitamento materno na primeira meia hora após o parto estiveram mais propensos a mantê-lo no domicílio. Oferta de substitutos do leite materno, chupetas ou bicos artificiais interfere negativamente no estabelecimento e manutenção da amamentação. Conclusão: conclui-se, que os dez passos influenciam na continuidade da amamentação e, portanto, é importante que se amplie a cobertura nacional da IHAC

Objective: To evaluate the evidence of Brazilian scientific production about the influence of the 10 steps to succeed on breastfeeding continuity. Method: integrative review of Brazilian scientific literature developed at the databases LILACS, SCOPUS and MEDLINE in June of 2017. Results: the standardization of care positively interferes on breastfeeding continuity. Health team training increases the prevalence of breastfeeding. Professional orientation on the advantages and management of lactation protects against mastitis, mixed suckling and early weaning. Those who received support in breastfeeding within the first half hour after delivery were more likely to keep it at home. Provision of breast milk substitutes, pacifiers or artificial nipples interferes negatively in stablishing and maintaining breastfeeding. Conclusion: it is concluded that the ten steps influence on the continuity of breastfeeding and, therefore, it is important to expand the Child Friendly Hospital Initiative national coverage

Objetivo: Evaluar la evidencia de la producción científica brasileña sobre la influencia de los 10 pasos para tener éxito en la continuidad de la lactancia materna. Método: revisión integral de la literatura científica brasileña desarrollada en las bases de datos LILACS, SCOPUS y MEDLINE en junio de 2017. Resultados: La estandarización del cuidado interfiere positivamente en la continuidad de la lactancia materna. La capacitación de los equipos de salud aumenta la prevalencia de la lactancia materna. La orientación profesional sobre las ventajas y el manejo de la lactancia protege contra la mastitis, la lactancia mixta y el destete precoz. Aquellos que recibieron apoyo en la lactancia durante la primera media hora después del parto tenían más probabilidades de mantenerlo en casa. La provisión de sustitutos de la leche materna, chupones o pezones artificiales interfiere negativamente en el establecimiento y mantenimiento de la lactancia materna. Conclusión: se concluye que los diez pasos influyen en la continuidad de la lactancia materna y, por tanto, es importante ampliar la cobertura nacional de la Iniciativa Hospital Amigo de los Niños

Recomendaciones sobre el diagnóstico y el tratamiento de la alergia a la proteína de la leche de vaca en población pediátrica colombiana - Posición de expertos / Expert recommendations for diagnosis and treatment of cow's milk protein allergy in the Colombian pediatric population

Resumen Objetivo: generar recomendaciones sobre el diagnóstico y el tratamiento de la alergia a la proteína de la leche de vaca (APLV), que sirvan de referencia y consulta para los médicos pediatras y de cuidado primario. Materiales y métodos: el presente documento de posición de expertos fue desarrollado por un grupo de médicos, especialistas en diferentes áreas terapéuticas y con experiencia en APLV. Se definieron los temas más relevantes y se realizó una revisión de la literatura científica disponible, a fin de elaborar una propuesta de recomendaciones que fue discutida por los autores. Resultados: se elaboró un documento de posición que propone un enfoque práctico sobre la definición, el diagnóstico y el tratamiento de la APLV en el paciente pediátrico. Conclusiones: el diagnóstico temprano y el manejo adecuado de la APLV pueden contribuir a una disminución de la carga de esta enfermedad y sus complicaciones.

Abstract Objective: The objective of this paper is to develop and present recommendations for diagnosis and treatment of Cow's Milk Protein Allergy (CMPA) which can serve as a reference for pediatric and primary care physicians to consult. Materials and methods: This expert position document was developed by a group of doctors who are specialists in several therapeutic areas who have experience in CMPA. The most relevant topics were defined and a review of the available scientific literature was carried out to prepare a proposal for recommendations that was then discussed by the authors. Results: A position paper was developed that proposes a practical approach to definition, diagnosis and treatment of CMPA in pediatric patients. Conclusions: Early diagnosis and proper management of CMPA can help decrease the burden of this disease and its complications.

Cytotoxic and genotoxic potential of industrialized powdered milk for infants and young children

This study aimed to evaluate the cytotoxicity and genotoxicity and determine the LC50 concentration of powdered infant formulas widely marketed in South American countries. To this, milk samples, called as A, B, C and D, were analyzed in root meristem cells of Allium cepa, at concentrations of 0.075; 0.15 and 0.30 g mL-1, for 24 and 48 hours; and through cell viability in culture of normal line cells, via MTT test, for 24 hours, in the concentrations 0.018; 0.0375; 0.075 and 0.15 g mL-1. In A. cepa, all dairy products in the three concentrations caused significant inhibition of cell division in the meristems within the first 24 hours of exposure. In the in vitro evaluation, all milk formulas at 0.15 g mL-1, as well as milk A at a concentration of 0.037 g mL-1, C at 0.075 g mL-1 and D at 0.037 g mL-1, significantly reduced the cellular viability of the cell culture exposed to the foods studied, being potentially toxic. The milk A was considered the most toxic, with LC50 of 0.031 g mL-1, and B as the least toxic, with LC50 of 0.15 g mL-1. Therefore, the milk evaluated caused significant instability in cells of the test systems used and were characterized as cytotoxic.

Concentraciones de los oligoelementos cobre y zinc en leche materna, de vaca y de cabra / Concentrations of trace elements like copper and zinc in breast, cow's and goat's milk

Objetivo: Comparar las concentraciones de los oligoelementos cobre y zinc en la leche materna, de vaca y de cabra. Métodos: Estudio descriptivo de corte transversal. Se recogieron muestras de leche materna de madres lactantes sanas (91 mujeres) que asistieron a un centro materno infantil en la ciudad de Maracaibo-Venezuela. Previo consentimiento informado se seleccionaron madres que cumplieron con los criterios de inclusión. Las concentraciones de los oligoelementos en estudio, se determinaron mediante espectrofotometría de absorción atómica con llama. Resultados: En el análisis de la muestra de leche humana se hallaron concentraciones de cobre de 0,290 ± 0,04 mg/L y concentraciones de zinc de 1,580 ± 0,35 mg/L. Estos valores son considerados aceptables según la ingesta diaria de referencia para estos oligoelementos y fueron más elevada en muestras en leche de cabra según la literatura, mientras que las concentraciones de zinc en ambas leches (cabra y vaca), registradas por otros especialistas, fueron más elevadas que en la leche humana del presente estudio. Conclusiones: Las concentraciones de cobre y zinc halladas en la leche materna en este trabajo son las ingestas recomendadas para el desarrollo y madurez del sistema nervioso central del neonato(AU)

Objective: To compare the concentrations of trace elements like copper and zinc present in breast, cow's and goat's milk. Methods: Descriptive, cross sectional study. Samples of breast milk were collected from healthy lactating mothers (91 women) who attended a maternal and children health center in Maracaibo city, Venezuela. Mothers were selected prior informed consent who met the inclusion criteria. The concentrations of the studied trace elements were determined by atomic absorption spectrophotometry with flame. Results: In the analysis of the human milk´s sample, there were found concentrations of Cu (0.290 ± 0.04 mg/L) and concentrations of Zn (1.580 ± 0.35 mg/L). These levels are considered acceptable according to the permitted intake of trace elements and according to the literature, those are higher in goat milk´s samples, while concentrations of Zn in both milks (goat and cow), registered by other specialists were higher than in the human milk´s of the present study. Conclusions: The concentrations of copper and zinc found in breast milk are the recommended daily intake for the development and maturity of the central nervous system of the newborns(AU)

Milk production units characterized by sanitary, nutritional and infrastructure variables in the northwest, center western and southwest mesoregions of Rio Grande do Sul, Brazil / Caracterização de unidades de produção de leite caracterizadas por variáveis ​​sanitárias, nutricionais e de infraestrutura nas mesorregiões noroeste, centro ocidental e sudoeste do Rio Grande do Sul, Brasil

Evaluating and characterizing production systems using farm characteristics allows the diagnosis of failing points. This diagnosis can be used to improve the productive and zootechnical indices. Little is known about the milk production systems in the state of Rio Grande do Sul, therefore, the aim of this study was to characterize the milk production systems of the Northwest, Center Western and Southwest mesoregions of Rio Grande do Sul, considering the infrastructure, milk handling, milk quantity and composition, and nutritional intake of the cattle. To conduct this study, 38 Milk Production Units (MPUs) registered at the Municipal Secretaries of Agriculture and Emater/Ascar-RS were randomly selected. After being randomly selected, the dairy farms were visited and a semi-structured guide questionnaire was applied and milk samples were collected from expansion tanks. The milk was analyzed for somatic cell counts (SCC) and total bacterial counts (TBC). Data were evaluated through principal component analysis and cluster analysis. Multivariate analysis allowed the investigated variables to be reduced into two main components (CP1 and CP2). These two showed eigenvalues greater than 1 (alpha> 1) and together explained 55.05% of the characteristics variability of the 38 MPUs studied. CP1 contemplated productive capacity and factors related to nutritional management of the MPUs, interfering directly with reproductive performance. CP2 comprised milk handling and daily production. Using these main variables, the data set generated from the 38 MPUs studied were adjusted and classified into five groups (G1, G2, G3, G4, and G5). The characteristics of these groups differed statistically especially in infrastructure and nutritional management of the cattle. Due to their particularities, each of these five groups of MPUs requires strategic technical interventions to improve their productive indexes. KEYWORDS: Management. Production Systems. Milk Quality. INTRODUCTIONThe milk activity is developed in milk production units (MPU) distributed throughout the Brazilian territory (WILLERS et al., 2014). These units have different characteristics regardless of the technological level adopted. The daily production and monthly remuneration play a fundamental role in the generation of jobs and income, moving the economy of the regions where they are inserted. However, the activity is developed in the MPUs under production systems with a wide range of organizational, technological, and production scales (BODENMÜLLER FILHO et al., 2010; WINCK; THALER NETO, 2012). Thus, each productive system has peculiar characteristics, which directly affect the productive efficiency of the MPUs. Rio Grande do Sul is the state in Brazil that produces the second largest volume of milk. In this Received: 08/04/19 Accepted: 30/12/19

Avaliar e caracterizar sistemas de produção utilizando as características das propriedades permite diagnosticar os pontos falhos, visando melhorar os índices produtivos e zootécnicos, desse modo pouco se sabe sobre os sistemas de produção de leite no estado do Rio Grande do Sul. Assim, objetivou-se com este estudo caracterizar os sistemas de produção de leite das mesorregiões Noroeste, Centro-Oeste e Sudoeste do Rio Grande do Sul, considerando a infra-estrutura, a quantidade, qualidade e composição do leite e o manejo nutricional dos rebanhos. Para conduzir este estudo, 38 Unidades de Produção de Leite (UPLs) registradas nas Secretarias Municipais de Agricultura e Emater/Ascar-RS foram selecionadas aleatoriamente. Depois, as fazendas leiteiras foram visitadas, um questionário semi-estruturado foi aplicado e amostras de leite do tanque foram coletadas. O leite foi analisado quanto à contagem de células somáticas (CCS) e à contagem bacteriana total (CBT). Os dados foram avaliados através de análise de componentes principais e análise de cluster. A análise multivariada permitiu que as variáveis investigadas fossem reduzidas em dois componentes principais (CP1 e CP2). Estes apresentaram autovalores maiores que 1 (alfa> 1) e juntos explicaram 55,05% da variabilidade das características das 38 UPLs estudadas. O CP1 contemplou a capacidade produtiva e os fatores relacionados ao manejo nutricional das UPLs, interferindo diretamente no desempenho produtivo. CP2 compreendeu manipulação de leite e produção diária. Utilizando essas variáveis principais, os dados gerados a partir das 38 UPLs estudadas foram ajustados e estas classificadas em cinco grupos (G1, G2, G3, G4 e G5). As características desses grupos diferiram estatisticamente, especialmente em infraestrutura e manejo nutricional do rebanho. Devido a suas particularidades, cada um desses cinco grupos de MPUs requer intervenções técnicas estratégicas para melhorar seus índices produtivos.

Sensory acceptance and physico-chemical composition of mixed minas frescal cheese / Aceitação sensorial e composição físico-química de queijo minas frescal misto

Buffalo milk presents higher proteins and lipids concentration than cow milk, which provides a better yield in cheese-making production and products with considerable sensory approval. However, buffalo milk is not regularly available throughout the year due to different handling conditions. Thus, to guarantee the supply of buffalo milk dairy products during the year, the addition of bovine milk is an alternative. Therefore, this study aimed to test the effect of a buffalo and bovine milk mixture for the Minas Frescal cheese elaboration by physico-chemical, sensory analysis and obtaining yield. The raw material was analysed for the parameters of acidity, density, fat, total solids and solid-not-fat. There were 3 Minas Frescal cheeses elaborated from 3 formulations: 100% buffalo milk, 100% bovine milk and the mixture of 50% of each milk. The cheeses were submitted to the Gravimetric and Gerber methods to obtain values of moisture and fat, as well as to obtain, indirectly, fat in dry matter. For bovine and buffalo milk, the parameters evaluated (acidity, density, fat, total solids and solids-not-fat) complied with Brazilian legislation and parameters described in the literature. For the bovine, mixed and buffalo fresh cheeses, values were obtained, respectively, for moisture (74.04, 60.93 and 63.61), fat in dry matter (44.35, 42.23 and 46.03) and cheese yield (27, 20.8 and 24.2), indicating a higher yield for the bovine Minas Frescal cheese and higher fat content for the buffalo cheese. The overall acceptance of the mixed Minas Frescal cheese was significantly superior to the bovine and buffalo cheese. The parameters of colour, appearance, texture, flavour and overall acceptance were above 8 points in the hedonic scale ('moderately liked' to 'extremely liked'), and the aroma attribute scored was above 7 ('I enjoyed regularly' to 'moderately liked'). Therefore, the elaboration of Minas Frescal cheese from the mixture of 2 matrices (buffalo and bovine milk) demonstrated technological viability with the potential to meet the demands of the consumer market.

O leite de búfala possui maior porcentagem de todos os componentes tornando-o uma matéria-prima adequada com potencial para fornecer um maior rendimento e qualidade nutricional na produção de queijo. No entanto, o leite de búfalo não está disponível regularmente ao longo do ano devido a diferentes condições de manejo. Assim, para garantir a oferta de produtos lácteos com leite de búfala independentemente da época, a adição de leite bovino pode ser vista como uma alternativa. Logo, este trabalho teve como objetivo testar o efeito da mistura do leite de búfalo e bovino na elaboração do queijo Minas Frescal por meio de análises físico-químicas e sensoriais e obtenção do rendimento economico. A matéria-prima foi analisada quanto aos parâmetros: acidez titulável, densidade, gordura, sólidos totais e sólidos totais desengordurados. Três variedades de queijo Minas Frescal foram elaboradas a partir de três formulações: 100% de leite de búfala, 100% de leite bovino e da mistura de 50% de cada leite. Os queijos foram submetidos aos métodos Gavimetric e Gerber para obtenção de umidade e gordura, bem como, indiretamente, para obtenção de matéria gorda no extrato seco. Para o leite bovino e de búfala, os parâmetros avaliados (acidez titulável, densidade, gordura, sólidos totais e sólidos totais desengordurados) estavam de acordo com a legislação brasileira e parâmetros descritos na literatura. Para os queijos bovino, misto e de búfala, foram obtidos, respectivamente, para: umidade (74,04; 60,93 e 63,61), gordura na matéria seca (44,35; 42,23 e 46,03) e rendimento econômico (27, 20,8 e 24,2) indicando maior rendimento o queijo Minas Frescal bovino e maior teor de gordura para o queijo búfalo. A aceitação global do queijo Minas Frescal misto foi significativamente superior ao do queijo bovino e bubalino. Os parâmetros de cor, aparência, textura, sabor e aceitabilidade global foram acima de 8 pontos (entre "gostei moderadamente" e "extremamente gostei") e o atributo aroma obteve pontuação acima de 7 ("gostei regularmente" para "gostei moderadamente"). Portanto, a elaboração do queijo Minas Frescal da mistura de leite bovino ao búfalo demonstrou potencial para atender as demandas do mercado consumidor.

Calf rearing profile in agrarian reform settlements in Santana of Livramento, RS, Brazil / Perfil da criação de bezerras nos assentamentos de reforma agrária de Santana do Livramento, RS, Brazil

In agrarian reform settlements there are obstacles in the rearing of calves; however, the main aspects that cause this obstacle are not known. Thus, the aim of this study was to diagnose the main obstacles in the management of these dairy heifers to target extension actions.For this, semi-structured guided questionnaires were applied to 40 families from 20 settlements. The questionnaire contained questions about the characteristics of the family, property and general management, feeding and sanitation of calves. The data were tabulated in Excel, transformed into variables and studied by means of multivariate analysis of main components after the farms were grouped into clusters according to similarity. The variables that most affected the heifer rearing system in dairy farms in the agrarian reform settlements of Santana do Livramento, RS, Brazil, were related to diet and occurrence of diarrhoea in calves. The 40 farms studied were grouped into six clusters, which differed especially in relation to who was responsible for the management of the heifers inside the property, regarding the infrastructure for the calves, time in milk production and concern regarding the care in the breeding of the calves. Based on these differences between the clusters being correctly identified, the technicians who work in these farms can establish strategies to work with settled families, emphasising the points where the obstacles are known to trigger the survival of heifers that will replace the dairy herds.

Em assentamentos da reforma agrária há entraves na criação das bezerras, porém, não se conhece os principais aspectos que causam esses entraves. Assim, objetivou-se com este estudo, diagnosticar os principais entraves no manejo destas bezerras leiterias para direcionamento de ações de extensão. Para tal, foram aplicados questionários guia semiestruturados à 40 famílias de 20 assentamentos. O questionário continha questões sobre as características da família, propriedade e manejo geral, alimentar e sanitário das bezerras. Os dados foram tabulados em Excel, transformados em variáveis e estudados por meio de análise multivariada de componentes principais. Após as propriedades foram agrupadas em clusters segundo a similaridade. As varáveis que mais afetam o sistema de criação de bezerras em propriedades leiteiras nos assentamentos da reforma agrária de Santana do Livramento, RS, estão relacionadas à alimentação e ocorrência de diarreia nas bezerras. As 40 propriedades estudadas foram agrupadas em seis clusters, que se diferiram especialmente em relação à com quem fica a responsabilidade pelo manejo das bezerras dentro da propriedade, quanto à infraestrutura destinada às bezerras, tempo na produção de leite e preocupação em relação aos cuidados na criação das bezerras. Com base nestas diferenças existentes entre os clusters e corretamente identificadas, os técnicos que atuam nestas propriedades poderão estabelecer estratégias para trabalhar com as famílias assentadas, enfatizando os pontos onde sabidamente estão os entraves para deslanchar a criação das bezerras que irão substituir as matrizes leiteiras.

Determination of changes during storage in chemical and microbial compositions of yoghurts made from buffalo milk and buffalo and cow milk mixtures

This study was aimed to determine and compare the chemical and microbiological properties of yoghurts made from different types of milk and their mixtures (35%, 65%, and 100%) during their storage at 4 °C for 28 days. For this purpose, chemical and microbiological properties of yoghurts during storage at 4 °C for 28 days were investigated. The total amount of dry matter, fat, pH and protein of yoghurt made from the buffalo and cow milk mixtures was significantly higher than that of pure buffalo milk (P<0.01). Also, storage time has led to significant differences in these components. Considering the results of microbiological analysis, a significant (P<0.01) difference was found between yoghurt samples in terms of total count of mesophilic aerobic bacteria, lactobacilli, lactococcus and yeast and mould. Hence, it is concluded that the addition of buffalo milk to that of cow improves the composition of yoghurt made from cow milk, which indicated the possibilities of processing and marketing of both types of milk especially because the health benefits of cow milk and the fermented products are well documented(AU)

El objetivo de este estudio fue determinar y comparar las propiedades químicas y microbiológicas de los yogures hechos con diferentes tipos de leche y sus mezclas (35%, 65% y 100%) durante su almacenamiento a 4° C por 28 días. La cantidad total de materia seca, grasa, pH y proteínas del yogur hecho con las mezclas de leche de búfala y vaca fue significativamente mayor que la de la leche de búfala pura (P <0.01). Además, el tiempo de almacenamiento generó diferencias significativas en estos componentes. De acuerdo con los resultados del análisis microbiológico, se encontró una diferencia significativa (P<0.01) entre las muestras de yogur en términos de bacterias mesófilas aerobias totales, lactobacilos, lactococcus y recuentos totales de levadura y mohos. Por lo tanto, se concluye que la adición de leche de búfala a la de vaca mejora la composición del yogur hecho de leche de vaca, lo que indica las posibilidades de procesamiento y comercialización de ambos tipos de leche, especialmente porque los beneficios para la salud de la leche de vaca y de los productos fermentados están bien documentados(AU)

Feeding of HIV-exposed children in a city in south of Brazil: family capability, clinical and social conditions / Alimentação de crianças expostas ao HIV em um município do sul do Brasil: capacidade familiar, condição clínica e social

Abstract Objectives: to evaluate the association between the sociodemographic and clinical aspects of the caregiver and the child, the family's ability to prepare and administer milk and complementary feeding of children exposed to HIV. Methods: cross-sectional study performed with 72 caregivers, in Brazil, through the tool of sociodemographic and clinical characterization of the caregiver and the Capability to Care for HIV-Exposed Children Assessment Scale. Results: there was a high capability to feed (76.6%), both for milk (85.0%) and comple-mentary (65%) feeding. For the milk feeding, accessing the health unit in any situation (p=0.003), having other child exposed to HIV (p=0.013), maintaining the follow-up in the health service (p=0.048) and not consuming alcohol (p=0.045) influenced on the higher probability of the caregiver to present high capability, while residing in the peri-urban area (p=0.002) indicated moderate capability. For the complementary feeding, the higher the schooling (p=0.025), the number of appointments scheduled for the child (p=0.045) and the child being followed up in the health service (p=0.035), the higher the probability of obtaining high capability. Conclusions: the exposure of social and clinical factors of caregivers influences the ability to feed. To ensure adequate nutrition, it is necessary for the health services to be able to consider the geo-socio-cultural characteristics of families in the elaboration of guidelines.

Resumo Objetivos: avaliar a associação entre os aspectos sociodemográficos e clínicos do cuidador e da criança, a capacidade familiar para preparar e administrar a alimentação láctea e complementar de crianças expostas ao HIV. Métodos: estudo transversal realizado com 72 cuidadores, entre fevereiro de 2016 a março de 2017, por meio de instrumento de caracterização sociodemográfica e clínica do cuidador e Escala de Avaliação da Capacidade para Cuidar de Crianças Expostas ao HIV. Resultados: evidenciou-se alta capacidade para alimentar (76,6%), tanto para alimen-tação láctea (85,0%) quanto complementar (65%). Para a láctea, acessar a unidade básica em qualquer situação (p=0,003), ter outros filhos expostos ao HIV (p=0,013), manter o acompanhamento no serviço de saúde (p=0,048) e não consumir álcool (p=0,045) influen-ciou na maior probabilidade de o cuidador apresentar alta capacidade, enquanto que residir em zona periurbana (p=0,002) indicou capacidade moderada. Para a alimentação comple-mentar, quanto maior a escolaridade (p=0,025), o número de consultas da criança (p=0,045) e a criança estar em acompanhamento no serviço de saúde (p=0,035), maior a probabilidade de obter capacidade alta. Conclusões: a exposição dos fatores sociais e clínicos das cuidadoras influencia na capacidade para alimentar. Para garantir a alimentação adequada, é necessário que os serviços de saúde estejam aptos a considerar as características geo-sócio-culturais das famílias na elaboração das orientações.

Lactancia materna y alimentación complementaria en un grupo de niños y niñas atendidos por un programa de atención integral en Bogotá, Colombia / Breastfeeding and complementary feeding in a group of children participating in a comprehensive service program in Bogotá, Colombia

RESUMEN La situación nutricional de los niños menores de 2 años de edad está relacionada principalmente con su alimentación, la cual incluye lactancia materna exclusiva hasta los 6 meses de edad y una alimentación complementaria adecuada y segura desde los 6 meses de edad, manteniendo la lactancia materna hasta los 2 años o más, por tal razón se caracterizó la alimentación en un grupo de niños y niñas de O a 24 meses de la ciudad de Bogotá. Estudio descriptivo longitudinal, donde se aplicó encuesta alimentaria en 5 momentos a 388 madres de niños participantes, estableciéndose frecuencias simples, con intervalos de confianza al 95% y pruebas de diferencia Chi2. La Lactancia Materna (LM) en la primera hora de vida fue 68,8%, a los 2 meses 96.1% y esta prevalencia disminuyó gradualmente a 43,3% a los 24 meses. La prevalencia de lactancia materna exclusiva hasta los 6 meses fue 22,9% y la duración media 2,9 meses. El suministro de leche artificial inició a los 0 meses, alcanzó el 60% a los 6 meses. El 50% de los niños y niñas había iniciado alimentación complementaria alrededor de los 2 meses de edad. En la mayoría de los niños, a los 24 meses no cumplían con el consumo establecido de frutas, verduras y carnes, así mismo, con la recomendación mundial de lactancia materna exclusiva debido al suministro temprano de leche artificial y otros alimentos.

ABSTRACT The nutritional status of children under 2 years of age is mainly related to their diet, which includes exclusive breastfeeding until 6 months of age and adequate and safe supplementary feeding from 6 months of age, maintaining breastfeeding for 2 or more years. For this reason, feeding was characterized in a group of children from 0 to 24 months of the city of Bogotá. We conducted a longitudinal descriptive study, where a food survey was completed on 5 occasions by 388 mothers of participating children, establishing simple frequencies, with 95% confidence intervals and Chi2 difference tests. Breastfeeding (BF) in the first hour of life was 68.8% and 96.1% at 2 months. This prevalence gradually decreased to 43.3% at 24 months. The prevalence of exclusive breastfeeding up to 6 months was 22.9% and the average duration was 2.9 months. The supply of artificial milk began at 0 months and was 60% at 6 months. 50% of children had started complementary feeding around 2 months of age. At 24 months, children's diets did not meet the established norms for consumption of fruits, vegetables and meats. Due to the early supply of artificial milk and other foods, the worldwide recommendation to exclusively breastfeed was also not met.

Bean coproduct as source of protein in dairy cows diets / Coproduto do feijão como fonte proteica em dietas para vacas leiteiras

The objective of this study was to evaluate the supplementation of dairy cows with different protein sources in relation to intake, digestibility, production and chemical composition of milk. For this, eight crossbred cows (Hostein x Gir) were used, distributed in two simultaneous latin squares (4x4). The treatments used were: bean coproduct, soybean meal, sunflower meal and cottonseed meal. Four variance-covariance structures were tested by means of the Akaike criterion corrected to determine the best fit to the data, and afterwards they were submitted to analysis of variance, and the means of the treatments were compared by the Tukey's test, at 5% probability. Only intakes of crude protein and crude fat were influenced by the treatments, for the digestibility, regardless of the evaluated nutrient, the soybean meal was the best treatment or was among the best, a behavior also observed for milk production. Thus, it was concluded that soybean meal is the best source of protein among the supplements used, and the bean coproduct stands out as a low-cost protein source but should not fully replace soybean meal, especially in animal categories of higher nutritional requirement.

Objetivou-se com este estudo avaliar a suplementação de vacas leiteiras com diferentes fontes proteicas em relação ao consumo, digestibilidade, produção e composição química do leite. Para tanto, utilizou-se oito vacas mestiças (Holandês x Gir), distribuídas em dois quadrados latinos (4x4) simultâneos. Os tratamentos utilizados foram: coproduto do feijão, farelo de soja, farelo de girassol e farelo de algodão. Foram testadas quatro estruturas de variância-covariância por meio do critério de Akaike corrigido para determinar o melhor ajuste aos dados, e posteriormente foram submetidas à análise de variância, sendo as médias dos tratamentos comparadas pelo teste de Tukey, a 5% de probabilidade. Apenas os consumos de proteína bruta e gordura bruta foram influenciados pelos tratamentos, já em relação a digestibilidade, independente do nutriente avaliado o farelo de soja foi o melhor tratamento ou esteve entre os melhores, comportamento este observado também para a produção de leite. Com isso, concluiu-se que dentre os suplementos utilizados o farelo de soja é a melhor fonte proteica, e o coproduto de feijão se destaca como uma fonte proteica de baixo custo, mas que deve substituir integralmente o farelo de soja, principalmente em categorias animais com alta exigência nutricional.

Residuos de pesticidas organoclorados en leche pasteurizada distribuida en Montería, Colombia / Organochlorine insecticide residues in pasteurized milk distributed in Monteria Colombia

RESUMEN Objetivo Determinar y cuantificar residuos de pesticidas organoclorados en leche de vaca pasteurizada distribuida en la ciudad de Montería, Colombia. Materiales y Métodos Se colectaron y analizaron 144 muestras durante seis meses (junio-diciembre 2013) de ocho marcas comerciales identificadas como A, B, C, D, E, F, G, H. Mensualmente se realizó un muestreo simple por atributo. Los POCs (puntos de contacto) fueron determinados usando un cromatógrafo de gas con detector captura de electrones, columna capilar RTX-5 (30.0 m longitud x 0.25 mm diámetro interno, 0.25 µÎ¹τι espesor de película). Resultados En las muestras analizadas se observó la presencia de pesticidas organoclorados, excediendo el Límite Máximo Residual establecido por el Codex Alimentarius. Las concentraciones encontradas fueron: 0.53; 0.15; 0.57; 0.40; 0.22; 0.20; 0.014; 0.002 y 0.028 mg/Kg de Σα-HCH/ß-HCH, γ-HCH, δ-HCH, ΣAldrín/Dieldrín, ΣHeptacloro/Heptacloro epóxido, Endrín, α-Clordano, γ-Clordano y Endosulfán I, respectivamente. La marca con mayor número de residuos de pesticidas detectados durante el estudio fue la A. La marca G presentó mayor concentración de residuos de pesticidas totales con 1.46 mg/Kg. Las marcas C y D presentaron, concentraciones menores de 0.72 y 0.0016 mg/Kg, δ-HCH y γ-Clordano respectivamente. Conclusiones Las muestras de leche pasteurizada bajo estudio, presentan residuales de pesticidas organoclorados por encima del límite máximo residual establecidos por el Codex Alimentarius, indicando un riesgo para la salud pública especialmente para los niños que es un subgrupo de la población más vulnerable.(AU)

ABSTRACT Objectives To determine and quantify organochlorine pesticide residues in pasteurized cow's milk distributed in the city of Monteria, Colombia. Materials and Methods 144 samples were collected and analyzed for six months (June-December 2013) from eight commercial brands identified as A, B, C, D, E, F, G, H. Simple sampling by attribute was carried out monthly. The POC (points of contact) were determined using a gas chromatograph with electron capture detector, with a capillary column RTX-5 (30.0 m long x 0.25 mm internal diameter, 0.25 pm film thickness). Results The samples analyzed showed organochlorine pesticides, exceeding the maximum residue limit established by the Codex Alimentarius. The concentrations found were: 0.53; 0.15; 0.57; 0.40; 0.22; 0.20; 0.014; 0.002 and 0.028 mg/Kg of Σα-HCH/ß-HCH, γ-HCH, δ-HCH, ΣAldrin/Dieldrin, ΣHeptachlor/Heptachlor epoxide, Endrin, α-chlordane, γ- chlordane and Endosulfan I, respectively. The brand with the highest number of pesticide residues detected during the study was A. The G brand had the highest concentration of total pesticide residues with 1.46mg/Kg. The C and D brands had lower concentrations with 0.72 and 0.0016mg/Kg, and δ-HCH and γ- chlordane, respectively. Conclusions The samples of pasteurized milk under study had organochlorine pesticides residue levels above the maximum residue limit established by the Codex Alimentarius, indicating a risk to public health, especially in children, which the most vulnerable sub-group.(AU)

La alimentación con lactancia materna exclusiva es un factor de riesgo para osteopenia en prematuros menores de 1500 gramos y menores de 32 semanas de gestación en comparacion leche materna fortificada o leche de fórmula / Exclusive breastfeeding is a risk factor for osteopenia in preterm infants under 1500 grams and under 32 weeks of gestation compared to fortified breast milk or formula milk

Contexto: La osteopenia o enfermedad ósea metabólica del prematuro, consiste en una mineralización ósea insuficiente de origen multifactorial que afecta principalmente a recién nacidos pretérminos. Propósito: Determinar si la leche materna exclusiva es un factor de riesgo de osteopenia en prematuros menos de 1500 gramos y menos de 32 semanas de gestación. Material y métodos: Estudio descriptivo, epidemiológico, observacional, transversal de dos cohortes para comparar la osteopenia entre aquellos que consumen leche materna exclusiva versus los que reciben alimentación mixta (leche materna-leche de fórmula). Población 406 casos ingresados en Unidad de cuidados intensivos neonatales del Hospital Docente de Calderón- Hospital Roberto Gilbert Elizalde de Abril - Noviembre 2018. Muestra 209 prematuros. Resultados: Se analizaron 209 prematuros de bajo peso < 1.500 gramos y con edad gestacional < 32 semanas de gestación que fueron alimentados con leche materna o mixta, sexo femenino (n=109; 52,15%) y sexo masculino (n= 100; 47,85%); recibieron leche materna exclusiva (n=99; 47,37%), mientras que el (n=110; 52,63%) recibieron lactancia mixta. Se comparó los parámetros bioquímicos que forman parte del perfil de osteopenia entre los prematuros de bajo peso con lactancia materna versus lactancia mixta; los resultados muestran diferencias significativas para todos los parámetros con p-valor de 0,000; donde para el calcio la media fue de 9,23 mg en lactancia materna y 10,43 mg en mixta; la media del fósforo se ubicó en 2,94 mg en lactancia materna y 4,71 mg en mixta; por último la fosfatasa alcalina presentó promedio de 651,85 UI/L en lactancia materna y 395,51 UI/L en mixta; siendo significativas las diferencias entre estos grupos con p-valor 0,000. Conclusión: Los prematuros que recibieron leche materna exclusiva presentan mayor riesgo de desarrollar osteopenia en relación con los prematuros que recibieron lactancia mixta.

Context: Osteopenia or metabolic bone disease of prematurity, consists of an insufficient bone mineralization of multifactorial origin that mainly affects preterm newborns. Purpose: To determine if exclusive breast milk is a risk factor for osteopenia in premature babies less than 1500 grams and less than 32 weeks of gestation. Material and methods: A descriptive, epidemiological, observational, cross-sectional study of two cohorts to compare osteopenia between those who consume exclusive breast milk versus those who receive mixed feeding (breast milk-formula milk). Population 406 cases admitted to the Neonatal Intensive Care Unit of the Teaching Hospital of Calderón Hospital Roberto Gilbert Elizalde in April - November 2018. It shows 209 premature infants. Results: We analyzed 209 premature infants of low weight <1,500 grams and with gestational age <32 weeks of gestation that were fed with breast milk or mixed, female sex (n = 109, 52.15%) and male sex (n = 100; 47.85%); they received exclusive breast milk (n = 99, 47.37%), while (n = 110, 52.63%) received mixed breastfeeding. We compared the biochemical parameters that are part of the profile of osteopenia among low birth weight premature infants with breastfeeding versus mixed lactation; the results show significant differences for all parameters with p-value of 0.000; where for calcium the average was 9.23 mg in breastfeeding and 10.43 mg in mixed; the average phosphorus was 2.94 mg in breastfeeding and 4.71 mg in mixed; finally, alkaline phosphatase presented an average of 651.85 IU / L in breastfeeding and 395.51 IU / L in mixed; being significant the differences between these groups with p-value 0.000. Conclusion: Preterm infants who received exclusive breast milk presented a higher risk of developing osteopenia in relation to preterm infants who received mixed breastfeeding.

Desenlaces del tratamiento con una fórmula extensamente hidrolizada a base de suero en lactantes con alergia a la proteína de leche de vaca / Outcomes of treating infants with cow's milk protein allergies with an extensively hydrolyzed serum-based formula

Resumen Introducción: la alergia a la proteína de leche de vaca (APLV) es la alergia alimentaria más frecuente en el primer año de vida. La evidencia actual acerca de la respuesta a una fórmula extensamente hidrolizada (FEH) a base de suero es insuficiente. Objetivo: determinar los desenlaces clínicos en lactantes con APLV a una FEH a base de suero (Nutrilón Pepti Junior®). Metodología: estudio retrospectivo, tipo serie de casos. Se incluyeron lactantes (≤12 meses) con APLV valorados en la consulta externa entre enero de 2011 y octubre de 2015 en un servicio de gastroenterología pediátrica. La información de datos demográficos, manifestaciones digestivas, tiempo de inicio de síntomas, antropometría y respuesta clínica a la fórmula fue abstraída a partir de la revisión de la historia clínica. Se comparó el estado nutricional de los pacientes en la primera y en la consulta de control un año después utilizando la prueba t de Student. Resultados: se incluyeron 40 lactantes (42,5% varones) de 3,3 ± 2,4 meses, con síntomas como vómito/regurgitación, cólico/irritabilidad y deposición con sangre. Los antecedentes familiares y perinatales relacionados con el desarrollo de APLV fueron la ingesta de biberón en la primera semana de vida: 27 (67,5%), madre ≥30 años: 33 (82,5%), atopia en 2 familiares: 12 (30%) y parto por cesárea: 30 (75%). 37 (92,5%) pacientes mostraron una respuesta positiva a una FEH a base de suero, mientras que 3 (7,5%) pacientes no respondieron y requirieron una fórmula a base de aminoácidos (FAA) libres. Los z-score de peso/edad: -0,69 ± 1,03 y peso/talla: -0,79 ± 1,00 de la primera consulta mejoraron en el seguimiento posterior al año (p <0,05): peso/edad: -0,27 ± 0,98 y peso/talla: -0,14 ± 0,98. Conclusión: se encontró recuperación nutricional y tolerancia a la leche de vaca en un alto porcentaje de lactantes con APLV que recibieron una FEH a base de suero.

Abstract Introduction: Cow's milk protein allergies (CMPA) are the most frequent food allergies in the first year of life. Current evidence about responses to an extensively hydrolyzed serum based formula is insufficient. Objective: This study's objective was to determine clinical outcomes in infants with CMPA to an extensively hydrolyzed serum based formula (Nutrilón Pepti Junior®). Methodology: This is a retrospective case series study of infants 12 months old or younger diagnosed with CMPA in the outpatient clinic of a pediatric gastroenterology service between January 2011 and October 2015. Information including demographic data, digestive manifestations, time of onset of symptoms, anthropometry and clinical responses to formula was abstracted from a review of clinical histories. Patients' nutritional statuses at first and one year follow-up consultations were compared using Student's t-test. Results: Forty infants (42.5% males) whose average age was 3.3 ± 2.4 months were included. Their symptoms included vomiting/regurgitation, colic/irritability and bloody stools. Family and perinatal history related to the development of CMPA included bottle feeding in the first week of life (27 patients, 67.5%), mothers who were thirty years of age or older (33 patients, 82.5%), atopy in two family members (12 patients, 30 %) and cesarean deliveries (30 patients, 75%). Thirty-seven patients (92.5%) responded positively to an extensively hydrolyzed serum based formula while three patients (7.5%) did not respond and required a milk-free amino acid based formula. The first consultation z-score of P/E was -0.69 ± 1.03 while the first consultation z-score of P/T was -0.79 ± 1.00. These improved at the one year follow-up to (p <0.05) P/E: -0.27 ± 0.98 and P/T: -0.14 ± 0.98, respectively. Conclusion: Nutritional recovery and tolerance to cow's milk was found in a high percentage of infants with CMPA who received an extensively hydrolyzed serum based formula.

Knowledge and practice of pediatricians and nutritionists regarding treatment of cow's milk protein allergy in infants / Conhecimento e prática de pediatras e nutricionistas sobre o tratamento da alergia às proteínas do leite de vaca em lactentes

ABSTRACT Objective This study evaluated the knowledge and practices of pediatricians and nutritionists about cow's milk protein allergy in infants, with an emphasis on issues related to the exclusion diet and nutritional status. Methods A cross-sectional, descriptive study was performed with a convenience sample of 204 pediatricians and 202 nutritionists randomly invited in scientific events in the city of São Paulo, from November 2014 to March 2016. Results Between 1.5% and 21.0% of respondents indicated inadequate products for the treatment of cow's milk protein allergy, including goat's milk, beverages or juices based on soy extract, lactose-free milk formula and partially hydrolyzed formula. The daily calcium recommendation for children between zero and 36 months of age was correctly indicated by 27.0% of pediatricians and 46.0% of nutritionists (p=0.001). Additionally, 96.1% of pediatricians and 82.7% of dietitians (p<0.001) provided guidance on about labels of industrialized products. Conclusion Pediatricians and nutritionists present gaps in knowledge about cow's milk protein allergy treatment in infants and educational strategies that increase the knowledge of the professionals are important for the management of cow's milk protein allergy.

RESUMO Objetivo Este estudo avaliou o conhecimento e práticas de pediatras e nutricionistas sobre alergia às proteínas do leite de vaca em lactentes, com ênfase em questões relacionadas à dieta de exclusão e ao estado nutricional. Métodos Estudo transversal, descritivo, realizado com uma amostra de conveniência de 204 pediatras e 202 nutricionistas, convidados aleatoriamente em eventos científicos na cidade de São Paulo, de novembro de 2014 a março de 2016. Resultados Entre 1,5% e 21,0% dos entrevistados indicaram produtos inadequados para o tratamento da alergia às proteínas do leite de vaca, incluindo leite de cabra, bebidas ou sucos à base de extrato de soja, fórmula de leite sem lactose e fórmula parcialmente hidrolisada. A recomendação diária de cálcio para crianças entre zero e 36 meses de idade foi corretamente indicada por 27,0% de pediatras e 46,0% de nutricionistas (p=0,001). Além disso, 96,1% dos pediatras e 82,7% dos nutricionistas (p<0,001) forneceram orientação sobre os rótulos dos produtos industrializados. Conclusão Pediatras e nutricionistas apresentam lacunas no conhecimento sobre o tratamento da alergia às proteínas do leite de vaca em lactentes. Estratégias educacionais que aumentam o conhecimento dos profissionais são importantes para o gerenciamento da alergia às proteínas do leite de vaca.

Factores asociados a la lactancia materna en mujeres de un municipio colombiano / Breastfeeding determinants in women of a Colombian municipality

Introducción: la lactancia materna es una de las estrategias más costo-efectivas para disminuir la morbimortalidad infantil. UNICEF afirma que la lactancia materna exclusiva en la población infantil mundial fue 38%. La Encuesta Nacional de Demografía y Salud reportó que Caldas-Risaralda-Quindío tienen la menor duración de Lactancia materna en Colombia, y la Lactancia materna Exclusiva en Risaralda es de 2.1 meses. Identificar los factores que determinaron la adherencia y el abandono de la lactancia materna en madres de dos comunidades de Dosquebradas, Colombia y el papel del profesional de la salud. Métodos: estudio de corte transversal sobre una muestra de 117 madres a quienes se aplicó una encuesta que indagó por aspectos biopsicosociales que impactan sobre la lactancia materna. Resultados: la duración de la lactancia materna exclusiva tuvo una mediana de 5 meses y la complementaria una mediana de 10 meses La principal causa de adherencia fue “es el alimento ideal” (27,9%) y de abandono fue “poca producción de leche” (58,1%). Los factores que impactaron significativamente la duración la lactancia materna exclusiva fueron la ocupación de la madre, incomodidad al lactar, uso de sucedáneos de la leche y tiempo de lactancia materna complementaria. El rol del profesional de salud no impactó la duración de la lactancia materna. Conclusiones: existe una amplia brecha entre lo recomendado por la Organización Mundial de la Salud y lo practicado por las comunidades.

Introduction: breastfeeding is one of the most cost-effective strategies to decrease infant morbidity and mortality. UNICEF affirms that exclusive breastfeeding is 38 % for infant world population. The Encuesta Nacional de Demografía y Salud reported that Caldas-Risaralda-Quindío have the shortest breastfeeding periods in Colombia, and exclusive breastfeeding periods averaging 2.1 months in Risaralda. Identify the factors that influence adherence and abandonment of breastfeeding, and the role of health care professionals, in mothers of two Colombian communities. Methods: it is a cross-sectional study on a representative sample of 117 mothers who completed a survey of biopsychosocial aspects that have an impact on breastfeeding. Results: a median of 5 months of exclusive breastfeeding and a median of 10 months of total breastfeeding was found. The main adherence reason was “it’s the ideal food” (27,9 %) and the main abandonment reason was “low milk supply” (58,1 %). It became clear that mother’s occupation, breastfeeding discomfort, use of breast-milk substitutes and complementary feeding duration, significantly impacts on exclusive breastfeeding duration. The role of health care professional didn’t impact on the breastfeeding time. Conclusions: there is a huge gap between the World Health Organization recommendations and the practice of the community.

Prevalencia de alergia a la proteína de la leche de vaca en niños en un hospital universitario de comunidad / Prevalence of cow's milk protein allergy among children in a university community hospital

La alergia a la proteína de la leche de vaca (APLV) es la alergia alimentaria más frecuente en pediatría. Existen pocos estudios que han evaluado la prevalencia de esta enfermedad en Argentina. Objetivos. Estimar la prevalencia de la APLV y describir su variación durante un período de 11 años. Pacientes y métodos. Se realizó un estudio de cohorte retrospectivo en recién nacidos vivos pertenecientes al programa de atención médica de un hospital universitario de comunidad. Resultados. Se identificaron 116 casos de niños con APLV. La prevalencia acumulada fue de 0,8% (intervalo de confianza -le- 95%: 0,65-0,95). Se observó un incremento porcentual de casos por año, de 0,4% en 2004 a 1,2% en 2014. Conclusión. La prevalencia de APLV fue del 1,2% en 2014, tres veces superior a la prevalencia en 2004.

Cow's milk protein allergy (CMPA) is the most common food allergy in pediatrics. In Argentina, the prevalence of this dis-ease has been evaluated in a few trials.Objectives. To estimate the prevalence of CMPA and describe its variation throughout a period of 11 years.Population and methods. A retrospective cohort study was carried out in live newborn infants enrolled in a health care program of a university community hospital.Results. One hundred and sixteen cases of children with CMPA were identified. Cumulative prevalence was 0.8% (95% confi-dence interval [CI]: 0.65-0.95). A percent increase of 0.4% in 2004 to 1.2% in 2014 was observed in the number of cases per year.Conclusion. In 2014, CMPA prevalence was 1.2%, i.e. three times that of 2004.

Milk quality in Brazil: an overview of official analysis of sanitary monitoring / Qualidade do leite no Brasil: um panorama de análises oficiaisde monitoramento sanitário

O leite beneficiado compõe uma parte importante dos alimentos mais consumidos e comercializados no mundo; no entanto, é reconhecido como um dos alimentos mais frequentemente fraudados, necessitando de monitoramento contínuo de qualidade. Objetivou-se no trabalho estudar a qualidade do leite beneficiado no Brasil, monitorado pelo Programa Oficial do Centro Integrado de Monitoramento da Qualidade de Alimentos (CQUALI-Leite), como subsídio para melhoria e aperfeiçoamento deste programa, direcionando ações corretivas para melhoria de produtos com foco em regiões de maior problemática. Para isso, foram avaliados os resultados de análises fiscais oficiais, totalizando 1556 amostras de leite beneficiado de diversas marcas comerciais disponibilizadas no comércio nacional. Os resultados obtidos evidenciaram que o leite pasteurizado foi a categoria com maior índice de irregularidades e o leite em pó a categoria de melhor qualidade, apesar de evidenciar a presença de Bacillus cereus, o que não pode ser negligenciado no controle sanitário. Concluiu-se que toda cadeia de processamento do leite beneficiado no Brasil ainda necessita de aprimoramento e monitoramento contínuos e que para aperfeiçoamento do CQUALI-Leite infere-se que o direcionamento de ações corretivas para melhoria de produtos deverá ter foco nas regiões Norte e Nordeste, principalmente quanto ao leite pasteurizado.

The processed milk makes up an important part of the food consumed and marketed in the world; however, it is acknowledged as one of the most frequently susceptible food to fraud practices, in need of continuous monitoring of quality and safety. This study aimed to assess the quality of milk processed in Brazil, monitored by the Official Program of the Integrated Center for Food Quality Monitoring (CQUALI-Milk), as a subsidy for improvement and enhancement of this program, focusing corrective actions to improve products with attention on problematic regions. For this, we evaluated the results of official analysis, totalizing 1556 samples of milk from several commercial brands available in the Brazilian retail market. The results show that pasteurized milk was the category with the highest rate of irregularities and the milk powder the category exhibiting the best quality, despite the evidence of Bacillus cereus, which cannot be overlooked in the sanitary control. Milk processing chain in Brazil still needs improvement and a continuous quality monitoring, and to enhance the CQUALI-milk we shall infer that the targeting of corrective actions to improve products should be focused in the North and Northeast regions, especially regarding the pasteurized milks.